Clinical trials are vital to science, yet researchers keep moving the goalposts 📨 Read StuartJRitchie's latest newsletter
Even when scientists are given rules to follow, they’re good at finding ways around themThis is Science Fictions with Stuart Ritchie, a subscriber-only newsletter from i. If you’d like to get this direct to your inbox, every single week,Imagine I said to my editor I was going to write today’s article about, say, antidepressants. “Okay”, he replies, “that’s a good topic. I’ll put you down for one on antidepressants, then.
If this happened in the context of a newspaper article, it would perhaps be puzzling , but it probably wouldn’t be a massive deal in the grand scheme of things. But in science, planning to do one thing then doing another is rife – and it has big consequences for how we understand important areas of research.
One of those rules is trial pre-registration: if you’re doing a clinical trial, you have to register your plans for the trial in aIn that registration, you have to say what the trial is going to be about. Specifically, you have to declare what yourwill be. That’s the main result, assessed after the trial ends, that essentially tells you whether the trial worked or not.
They looked at what the studies had declared as their primary endpoint, and checked to see whether by the time of publication they had either:mysteriously not mentioned the primary endpoint at all;Out of 755 trials, 145 – that’s 19.2 per cent – did one of these “One in five trials having an outcome switched is a big problem. It implies that more statistical analyses were run than were revealed, which could easily mean a higher rate of untrue, false-positive results.
But then, for full transparency, you’d want the authors of the study to tell us why they switched the outcome. Unfortunately, the new study found, fewer than a third of the articles with outcome switches actually explained what they’d done and why they’d done it. Again, that’s not a brilliant signal of integrity on the part of the triallists.
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